• Journal of Korean Ophthalmic Optics Society
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• v.13 no.1
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• pp.15-20
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• 2008

Purpose: To study on the confidence of dry eye diagnosis methods which need to prescribe contact lens. Methods: Non-invasive tear film break-up time (NIBUT) and tear film break-up time (TBUT) were measured in forty healthy subjects in their 20s, and then the subjects were classified into normal eye and dry eye. The results of McMonnies questionnaire, tear prism height measurement, Hardtack test, blink rate measurement and Schirmer test were compared with the results of NIBUT and TBUT. Results: The results of NIBUT and TBUT were as follows; 20 subjects had normal eyes, 10 subjects had dry eyes in both NIBUT and TBUT, and 10 subjects showed different results. In McMonnies questionnaire, the score of normal eye group averaged 8.2 and that of dry eye group averaged 18.5, which showed statistically significant difference. Furthermore, 100% of normal eye group classified by the results of NIBUT and TBUT corresponded with the result of McMonnies questionnaire and 90% of dry eye group showed the correspondence. Tear prism height of normal eye group averaged 0.32 mm and that of dry eye group averaged 0.23 mm, which were significantly different. Hardtack test, blink rate measurement and Schirmer test without local anesthesia showed no statistically significant difference between normal eye group and dry eye group. Conclusions: On dry eye diagnosis methods, the results of McMonnies questionnaire and tear prism height measurement had close correlation with the results of NIBUT and TBUT.

• Journal of Korean Ophthalmic Optics Society
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• v.18 no.2
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• pp.93-99
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• 2013

Purpose: The aim of this study was to develop a dry eye test method using a paper based microfluidic device that improves inaccuracy caused by using one of current point-of-care dry eye tests such as Shirmer's. Methods: Wax printed hydrophilic chromatography papers were dyed with anthocyanin extracts to detect colorimetric display of liquid samples with varying pH. Fluid distribution rates were measured using artificial tears and human tears directly from 32 subjects. Results: With Shirmer's, fluid distribution rates with small amount of samples (less than $0.5{\mu}l$) were not displayed. However, with paper based microfluidic device, fluid imbibition distances over time were clearly showed. Also clinical results of dry eye from newly developed paper based microfluidic device showed correlation with the results from tear break up time tests. Conclusions: The newly developed paper based microfluidic devices were easy to use and exhibited more accurate clinical results than current dry eye point of care tests such as Shirmer's.

• Journal of Digital Convergence
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• v.14 no.6
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• pp.347-353
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• 2016

Dry eye symptoms can occur by various environmental exposure. This study aimed to investigate the relationship between eye symptom especially dry eye and sunblocks. Study subjects were total 30 (28 male, 2 female) and NIBUT, McMonnies dry eye questionnaire, subjective questionnaire were performed. NIBUT after rubbing sunblocks was decreased compared to that of not-rubbing. Sunblocks C showed the largest difference of NIBUT value and was chosen most uncomfortable sunblocks in subjective questionnaire. Half of the subjects (15) felt eyes discomfort after rubbing sunblocks and showed larger McMonnies dry eye questionnaire score than other subjects. The same result was founded about dry eye suspect criterion. Both showed borderline significant relation(p=0.049, p=0.051). This study suggested that sunblock could cause damage to the eyes and related to dry eye when rubbing sunblock around eyes. Because digital environmental factors could affect stimulus and modify the eyes, a convergence study will be required for additional research.

• Journal of Korean Ophthalmic Optics Society
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• v.9 no.2
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• pp.301-312
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• 2004

This study was performed to compare the relationship between contact lens wearer and dry-eye patient. In this study, TBUT, SIT, TTT, Rose bengal staining and McMonnies dry eye symptom questionnaire were performed as a baseline. With the base data, the subjects were classified to 3 groups : 3S patients who have dry eye signs and symptoms, 38 patients who are wearing soft contact tenses, 35 subjects who have health eyes and never worn on a contact lenses as control subjects. Contact lens wearers were divided into 3 groups according to the duration of contact lens wear. There were no significant differences in TBUT, STT, TTT, Rose-bengal staining and McMonnies dry eye symptom questionnaire result between contact lens wearer group and dry eye patients group. We suggest that there are similarities in tear function tests between the dry-eye patient and the contact lens wearer.

• Journal of Korean Ophthalmic Optics Society
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• v.5 no.2
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• pp.91-98
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• 2000

To investigate the distribution of dry eye and to accept diagnosis methods of dry eye in ophthalmic shop, this study was performed on 81 persons(male : 49, female : 32). 1. We divided two group for diagnosing dry eye by dry eye screening questionnaire : one was dry eye symptom group(49.3%) and the other was non-dry eye symptom group(50.7%). 2. Non-invasive break-up time(NIBUT) which was measured by using Tear $scope^{(R)}$ (Killer. co)was longer than invasive break-up time(IBUT). 3. A blink rate in dry eye symptom group(10%) was measured lesser than 10 cycle/min, in non-dry eye symptom group(14.9%). 4. In shirmer test there were lesser than 10mm/5min in dry eye symptom group(67.5%), in non-dry eye symptom group(39%). 5. Cornea and conjunctival staining by rose bengal represented Mild 25%, medium 36.25%, extreme 38.75% in dry eye symptom group. Non-dry eye symptom group was showed Mild 19.51%, medium 14.63%, extreme 12.19%. 6. These results showed that the patient showed dry eye symptom in 3 items of eye examination was 22.5%, 4 items 25%, 5 items 30%, 6 items 15%.

• Journal of Korean Ophthalmic Optics Society
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• v.15 no.4
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• pp.339-346
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• 2010

Purpose: The study was performed to compare the difference of non-invasive tear break-up time (NIBUT) with alignment or steep fitting of soft contact lens in normal and dry eyes. Methods: Total 40 eyes (aged 20~30 years) were classified to the normal (n=20) or dry eye group (n=20) by the diagnosis methods for dry eyes and worn soft contact lens (polymacon material) with alignment or steep fitting. NIBUTs of lens wearers were separately measured at the points of before wearing, immediately after wearing and after stabilization of tear film. Results: With alignment fitting, averaged NIBUT in the dry eye group after stabilization of tear film was not significantly different from that of the normal eye group. However, averaged NIBUTs in the normal and dry eyes had significant difference when measured immediately after lens wearing. However, the number of eyes having NIBUT less than 4.0 second was 30% higher compared to the number of normal eyes with steep fitting when measured immediately after wearing. Some shorten NIBUT in dry eyes with steep fitting was also shown after stabilization of tear film. Conclusions: These results suggest that wearing soft contact lens in dry eyes differently affect tear film compared to normal eyes. Thus, dry eyes need more advertent fitting for contact lens wearing because of unstable tear film.

• Journal of Korean Ophthalmic Optics Society
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• v.16 no.4
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• pp.375-381
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• 2011

Purpose: The purpose of this research was to see how wearing either a SCL or a C-SCL effected the dryness of a person's eye depending on how long they wear either type of lens. Methods: This study was carried out on 52 subjects (104 eyes) who were all in their twenties and had previously experienced wearing contact lenses. All of these subjects were required to wear either a SCL or a C-SCL, which were made out of the same material, for three months. Contents such as the McMonnies Questionnaire survey, the blinking rate per min. and the Noninvasive tear break-up time test (NIBUT) were later conducted on the subjects for this study. Results: According to the results of the McMonnies Questionnaire, it was concluded that the longer the subject wore the SCL and C-SCL, the value of the measurements gradually increased. On the other hand, the results from the NIBUT concluded that the longer the subject wore the SCL, the value of the measurements eventually decreased. However, according to the measurements of the blink rate test, it was concluded that neither results had a significant change. Conclusions: It was concluded that long-term wearing of SCL and C-SCL could be the cause of the induction and progression of dry eyes.

• Journal of Korean Ophthalmic Optics Society
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• v.9 no.2
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• pp.333-343
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• 2004

Impression cytology refers to application of cellulose acetate filter material to the ocular surface to remove the superficial layers of the conjunctival epithelium. The technique is non-invasive, is easy to perform, causes minimal discomfort to the patient, and can be used to follow changes in the conjunctival ocular surface over time. With this method, the morphology of the conjunctival ocular surface can be studied and the degree of squmaous metaplasia assessed. This study was performed to evaluate the conjunctival surface by impression cytology in dry eye patients. A total of 70 students with no contact lens wearing history were recruited. Subjects were required to fill in a McMonnies dry eye symptom questionnaire. The non-invasive tear thinning time(TIT) test of each subject was measured, followed by Schirmer tear test(STI), tear film break-up time(TBUT) tests and Rose-bengal staining were performed as a baseline. Conjunctival epithelial cells from the inferior bulbar conjunctiva were harvested by the impression cytology technique. The specimens collected were labelled and stained with PAS(Periodic Acid Schift)-haematoxylin. The goblet cells and conjunctival epithelial cells were observed under a light microscope of 400x magnification. The specimens were classified according to the Nelson Grading scale which was based on the degree of squamous metaplasia such as changes of goblet cells density, size/form, N:C(nucleus : cytoplasm) ratio. Dry eye patients were observed morphological changes of the epithelial cells, different nuclear alterations, decrease of the goblet cells density. The degree of cytological changes was related to severity of dry eye conditions. When the epithelial cell morphology was graded according to the system described by Nelson, specimens from the control group revealed 91.43% of the eyes to be grade 0 and 8.57% to be grade 1, whereas of the dry eye patients, 20% were grade 0, 42.86% grade 1, 34.29% grade 2 and 2,86% grade 3. Impression cytology represents a non- or minimally invasive biopsy of the ocular surface epithelium with no side effects or contraindications. It has demonstrated to be a useful diagnostic aid for a wide variety of processes involving the ocular surface. This technique is a safe, simple method and may help increase understanding of various ocular surface alterations in dry eye patients.

• Journal of Korean Ophthalmic Optics Society
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• v.20 no.4
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• pp.519-526
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• 2015

Purpose: To evaluate the changes of OSI value according to tear-film instability measured serially by OQAS(Optical Quality Analysis System, Visiometrics, Spain) every seconds. The presented study analyzed the relationship of the OQAS parameter with the results of the tear-film break-up time, Schirmer test, and the McMonies score. Methods: 147 eyes of 82 subjects were randomly selected from university students (age: $21.51{\pm}3.97$, male 45, female 37). Subjects were measured tear-film break-up time, Schirmer test, McMonies score and once every second for 15 seconds after blinking by continuous measurements from OQAS system. Results: The normal eye groups presented OSI values of $2.13{\pm}1.16$ while the dry eye groups had OSI values of $3.76{\pm}1.42$. Therefore, a significant difference between the normal eye group and dry eye group was discovered (p<0.05). In addition, the OSI value of all subjects increased over time. The OSI value, which was measured every second after blinking occurred, significantly increased between 6 seconds and 7 seconds after the start of the measurement (p<0.05). OSI cut off of 30% (sec.) showed a greater correlation; TBUT (r = 0.855, p = 0.000), McMonies test (r = -0.351, p = 0.003), Schirmer (r = 0.316, p = 0.012). Conclusions: Continuous measurement of OQAS showed a high correlation with the value of the existing dry eye tests. Therefore, Analysis of OSI values by utilization of OQAS could be useful in objectively evaluation of tear film in patients.

• Journal of The Korean Ophthalmological Society
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• v.59 no.12
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• pp.1103-1107
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• 2018

Purpose: To evaluate the clinical effect of intense regulated pulse light (IRPL) and changes in tear film thickness in dry eye patients. Methods: A retrospective study was conducted on 25 patients with Meibomian gland dysfunction who had subjective dry eye discomfort and whose tear film break-up time (TBUT) was < 10 seconds. All patients were treated with IRPL three times on days 1, 15, and 45. TBUT, Schirmer 1 test results, cornea staining score with fluorescein, ocular surface disease index (OSDI), and lipid layer thickness were measured and compared before and after the procedure. Results: TBUT was significantly increased from $3.7{\pm}1.2s$ to $4.4{\pm}2.1s$ after IRPL (p = 0.03). Schirmer 1 test and cornea staining scores changed significantly (p < 0.01 and p = 0.01, respectively). OSDI also showed a statistically significant improvement from $39.5{\pm}17.5points$ to $30.4{\pm}18.7points$ (p = 0.01). However, no significant difference in lipid layer thickness was observed (p = 0.49). Conclusions: IRPL is an effective treatment modality to improve TBUT, Schirmer 1 test scores, cornea staining scores, and subjective dry eye symptoms.